Lecture 8 - Diabetes (mostly FA tbh)

Question 1

diagnosis of diabetes:
HbA1c > ____
fasting plasma glucose > ____
2 hour oral glucose tolerance test > _____

Answer 1

6.5%
126 mg/dL;
200 mg/dL

Question 2

Type 1 vs Type 2:
characterized by islet leukocytic infiltrate/inflamm = _____
islet amyloid polypeptide deposits = _____
stronger genetic predisposition = _____
ketoacidosis common = ____
hyperosmolar hyperglycemic state common = _____

Answer 2

type 1;
type 2;
type 2;
type 1;
type 2

Question 3

type 1 vs type 2:
associated with obesity leading to decreased insulin receptors = ____;
presence of glutamic acid decarboxylase Abs = _____;
HLA DR3, 4 associated = _____

Answer 3

type 2;
type 1;
type 1

Question 4

diabetes:

osmotic damage is due to ___ accumulation in organs with _____ and/or absent _____

Answer 4

sorbitol;

aldolase reductase, sorbitol dehydrogenase

Question 5

progression of nephropathy in diabetes:

____ arterioles first –> glomerular ____filtration –> micro____ –> _____ syndrome

Answer 5

efferent;
hyper;
albuminuria;
nephrotic

Question 6

three major effects leading to hyperglycemia in type II diabetes:

decreased _____, increased _____, increased _____

Answer 6

glucose uptake, glycogenolysis, gluconeogenesis

all due to insulin resistance and/or decreased secretion

Question 7

there is also ____ proteolysis and ____ lipolysis;

effect of the changes in lipolysis? = increased _____

Answer 7

increased, increased;

ketogenesis/ketoacidosis

Question 8

diabetes:

impaired ____ secretion and unopposed/increased ____ secretion

Answer 8

insulin, glucagon

Question 9

in the digestive tract, there is a ____ incretin effect in diabetes. in the kidneys, there is ____ glucose reabsorption. in the brain, there is ____ dysfunction

Answer 9

decreased, increased,

NT

Question 10

after a meal, glucagon usually ____ and insulin usually ____ in normal people

Answer 10

decreases, increases

Question 11

incretins:
_____ is released from the ____ cells in illeum and colon;
___ is released from ___ cells in the duodenum;

both stimulate insulin release in a glucose ____ manner; they ____ gastric emptying

Answer 11

GLP, L;
GIP, K;

dependent;
inhibit

Question 12

glucose:
usually reabsorbed in the ____ via _____;
what is renal threshold of plasma glucose concentration that can be fully absorbed?

Answer 12

PCT, SGLT1 and 2 (Na/Glucose symporter);

200 mg/dL;

fully saturated = 375 mg/min fyi

Question 13

the 3 poly’s of diabetes = ____;

also weight ____

Answer 13

polyuria, dipsia, phagia;

weight loss

Question 14

"LuRKS" pneumonic of things that (do or do not) have aldolase reductase
L =
R =
K =
S =

Answer 14

do have (ie only have aldolase reductase);

lens,
retina,
kidneys,
schwann cells

Question 15

3 infections that are def associated with diabetes (1 bacteria, 2 fungi)

Answer 15

mucor (+rhizopus) , candida, pseudomonas

Question 16

diabetes:

contractures in the ____ joints cause a positive prayer sign and table top sign

Answer 16

MCP

also PIP, DIP involved

Question 17

3 “lipo” findings at insulin injection sites =

Answer 17

lipodystrophy, atrophy, hypertrophy

Question 18

eye things (from pathoma):
retinal \_\_\_\_ take up sorbitol and die. this causes blood leakage and \_\_\_\_ --> retinal \_\_\_\_\_ --> blindness

Answer 18

pericytes;
aneurysm;
hemorrhage

Question 19

nonproliferative vs proliferative retinopathy:
damaged capillaries leak blood–> hemorrhage = ____;
from chronic hypoxia = _____;
new blood vessel formation = _____;
macular edema = _____

Answer 19

non;
prolifer;
prolifer;
non prolifer

Question 20

another name for nodular glomerulosclerosis = _____ _____;

first sign of this clinically is

Answer 20

kimmelsteil-wilson nodules;

proteinuria

Question 21

what drug is reno-protective for diabetic nephropathy?

Answer 21

ACE inhibitors

Question 22

why do ulcers and charcot joints occur in diabetics?

location most common?

Answer 22

peripheral neuropathy;

feet/ankles

Question 23

hyperosmolar hyperketotic state:
more common in type 1 or type 2?
state of profound \_\_\_\_\_\_;
increased or normal ketones?;
usually seen in \_\_\_\_ people who are v \_\_\_\_\_;
acidosis?

Answer 23

type 2;
hyperglycemia;
normal;
old, dehydrated';
nope

Question 24

metabolic syndrome WEIGHhT pneumonic:
WE =
IG = 
H = 
H =
T =

Answer 24

waist expanded (pear shaped);
Impaired glucose;
Hypertension;
HDL low;
TGs high